Chronic complex diseases are wide spread and their occurrence has been surging worldwide with an aging and an increasingly sedentary population. One of these complex diseases, namely arteriosclerosis, is a common cause of severe diseases such coronary heart disease (1). To prevent deaths and disabilities, it is important to identify individuals at risk, e.g, in the case of arteriosclerosis, at risk to develop cardiovascular events (2, 3). Several risk factor scoring systems have been developed for this purpose (4, 5). These scoring systems have several limitations (6). First, they contain a temporal and spatial bias: the baseline data from which the score formulas are derived were usually collected in the past, sometimes decades ago, and the individuals participating in the study cohort live in certain regions of the world. Thus, general lifestyle changes within a population which can occur over a short period of time and may have a strong impact on the risk factors for arteriosclerosis (7), are not being considered. Many diseases, including arteriosclerosis, are also affected by the genetic background which varies in populations from different continents (8). Second, most risk score calculations for diseases such as arteriosclerosis end at an age of 65 to 70 years because, e.g., cardiovascular events are highly prevalent in this age group. For this age group, the probability to develop cardiovascular events within the next 10 years is 50%, but drugs used to prevent such events have to be taken infinitely and their side effects are particularly common in the elderly (9, 10). Evidence-based guidelines to treat common disorders such as cardiovascular disease, osteoporosis or diabetes with a multitude of drugs have recently been discussed in the light of the increasing number of patients with more than one of these conditions (11). In order to avoid unnecessary or even harmful multidrug regimens, it is of great importance to allocate treatment precisely to the patients who need it and not to the general population above 70. Third, patients with cardiovascular risk factors (e.g. arterial hypertension, hyperlipidemia or diabetes), e.g., for arteriosclerosis are treated for them: they take antihypertensive, cholesterol or glucose lowering drugs, which all potentially affect the variables entering the prediction algorithm and therefore may influence the estimation of the current risk. Since some of these regimens (e.g. statins or angiotensin converting enzyme inhibitors (12, 13)) have beneficial effects on important pathogenic steps of symptomatic arteriosclerosis and may even revert arteriosclerotic lesions, the question arises whether and particularly when these treatments could be discontinued.
The publications and other materials, including patents, used herein to illustrate the invention and, in particular, to provide additional details respecting the practice are incorporated herein by reference in their entirety. For convenience, the publications are referenced in this text by numerals corresponding to those in the appended bibliography.
Thus, there is a need for accurate assessment of current disease activity for the individual patient to replace or supplement risk prediction tools which are based on probabilities rather than facts. Particularly in view of the fact that complex disease, such as cardiovascular disease, are emerging in less developed countries (14) where accessibility to, e.g., coronary catheterization or other modern vascular imaging facilities is limited, this assessment should preferably be based on data obtained, at least in part, from the patient in a concise, short and affordable examination.